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Skipping Meds Courts Danger

Dr. Emily Senay
CBS/The Early Show
For many people, taking medication is just a "sometimes" thing, and that can threaten their health.

Early Show medical correspondent Dr. Emily Senay says many people just don't follow doctors' orders when taking prescription drugs, and some people don't even fill prescriptions in the first place.

Why might someone skip a prescribed dose or doses?

For some, Senay says, it's just a matter of forgetting.

But the psychology of not taking your medicine can go much deeper. It can be a bother, another thing on your daily schedule that you need to remember. You may not like swallowing pills or rubbing an ointment on your skin. So, on one level, it's just unpleasant or inconvenient.

In addition, people frequently have a personal bias against taking medications. They assume that, the smaller the amount they take, the better off they will be. The problem with that thinking is that the medication was prescribed for a purpose, to treat a specific medical condition. And the medicine will only work, and help make you better, if you actually take it.

Sometimes, Senay notes, people are tempted to reduce their dose to make side effects go away. Many are pregnant women, who often tend to feel less is better.

But, the director of the federal Agency for Healthcare Research and Quality, Dr. Carolyn Clancy, told CBS News there's an irony there: Very often, people who don't take the amount prescribed cut the medicine's effectiveness in treating the condition. But side effects are generally just as potent for the lesser dose as for the proper dose. So, you're hurting yourself both ways: less effectiveness, and equal side effects.

Of course, as Dr. Sandra Kweder of the Food and Drug Administration told CBS News, if you feel that any side effect is stronger or less tolerable than you expect, tell your doctor immediately. He or she might tell you to cut your dose. But it's not something you should do on your own.

Senay stressed that serious consequences can result from not taking medicines.

Clancy says the failure to take them leads to higher numbers of visits to the doctor, to more hospitalizations and nursing home admissions, to the need for more lab tests and, of course, in the most serious of cases, it can even lead to a patient's death.

Of course, Senay observed, the most troublesome situation is when a patient doesn't fill a prescription at all. And Clancy says up to-one third of patients fit that category. So, the doctor assumes they're taking their medication, but they're not. But even people who do fill prescriptions and try to stick to the prescribed schedule can face consequences if they miss doses too often.

And missing doses of some meds is worse than other, Senay points out. Experts tell us people taking blood thinners can trigger a stroke or heart attack by missing doses. People who need medications to maintain their heart rhythm can also experience serious problems if they don't maintain their schedule. And, in a totally different area, a woman who fails to take her birth control pill a couple of days in a row would be wise to start relying on other contraception methods for the rest of her cycle. She'd be unable to count on the pill anymore during that time.

What about catching up if you miss doses?

That depends on the particular medication, Senay says. For some medications, when the time arrives for the next dose, you should just pick up where you left off. With these medications, you shouldn't take extra the next time, because that would be too much for your system at once. With others, and certain birth control pills fall into this category, there's a formula for making up doses you've missed by increasing subsequent doses. But there's no one rule. It differs from medication to medication. So, read the package instructions carefully, and strictly follow the instructions from your doctor for that particular medication.